Hepatic fat fractions were quantified by noncontrast (HFFnon-CE) and contrast-enhanced single-source dual-energy computed tomography in arterial phase (HFFAP), portal venous phase (HFFPVP) and equilibrium phase (HFFEP) using MMD in 19 nonalcoholic fatty liver disease patients. https://www.selleckchem.com/products/vtp50469.html The fat concentration was measured on fat (water)-based images. As the standard of reference, magnetic resonance iterative decomposition of water and fat with echo asymmetry and least-squares estimation-iron quantification images were reconstructed to obtain HFF (HFFIDEAL-IQ).
There was a strong correlation between HFFnon-CE, HFFAP, HFFPVP, HFFEP, fat concentration and HFFIDEAL-IQ (r = 0.943, 0.923, 0.942, 0.952, and 0.726) with HFFs having better correlation with HFFIDEAL-IQ. Hepatic fat fractions did not significantly differ across scanning phases. The HFFs of 3-phase contrast-enhanced computed tomography had a good consistency with HFFnon-CE.
Hepatic fat fraction using MMD has excellent correlation with that of magnetic resonance imaging, is independent of the computed tomography scanning phases, and may be used as a routine technique for quantitative assessment of HFF.
Hepatic fat fraction using MMD has excellent correlation with that of magnetic resonance imaging, is independent of the computed tomography scanning phases, and may be used as a routine technique for quantitative assessment of HFF.The aim of this study was to investigate the quantitative differences of dual-energy computed tomography perfusion imaging measurements in subsegmental pulmonary embolism (SSPE), between normal lung parenchyma (NLP) and hypoperfused segments (HPS) with and without thrombus on computed tomography angiography (CTA).
Lung attenuation, iodine density, and normalized uptake values were measured from HPS and NLP on iodine maps of 43 patients with SSPE. Presence of pulmonary embolism (PE) on CTA was recorded. One-way repeated-measures analysis of variance and Kruskal-Wallis analyses with post hoc comparisons were conducted.
The numbers of HPS with and without SSPE on CTA were 45 (55.6%) and 36 (44.4%), respectively. Lung attenuation of NLP was significantly different from HPS (P &lt; 0.001). Iodine density and normalized uptake values of HPS with PE were significantly lower than those of HPS without PE, which is significantly lower than NLP (P &lt; 0.001).
Subsegmental pulmonary embolism causes HPS on dual-energy computed tomography perfusion imaging, which demonstrates different iodine density and normalized uptake values depending on the presence of thrombus.
Subsegmental pulmonary embolism causes HPS on dual-energy computed tomography perfusion imaging, which demonstrates different iodine density and normalized uptake values depending on the presence of thrombus.The aim of the study was to investigate chest computed tomography (CT) findings and the value of CT in the diagnosis in children with suspected coronavirus disease 2019 (COVID-19).
Chest CT images of pediatric patients with suspected COVID-19 were retrospectively evaluated. Computed tomography findings were divided into 3 groups normal, consistent, and inconsistent with COVID-19. The sensitivity and specificity of CT were calculated by reference to reverse transcriptase polymerase chain reaction.
The study included patients with a mean age of 11.1 years (1 month-17 years). Of the patients, 43 (40.19%) had normal CT, 34 (31.77%) had CT findings consistent with COVID-19, and 30 (28.04%) had CT findings inconsistent with COVID-19. The sensitivity, specificity, positive predictive value, and negative predictive value of CT were 47.92%, 81.36%, 67.65%, and 65.75%, respectively.
Because the sensitivity of CT in the pediatric age group is low, it should be used cautiously for the evaluation of COVID-19 in the pediatric age group.
Because the sensitivity of CT in the pediatric age group is low, it should be used cautiously for the evaluation of COVID-19 in the pediatric age group.Postoperative pulmonary complications (PPCs) are one of the most important cause of perioperative morbidity and mortality in patients undergoing noncardiothoracic surgery, leading to increased hospital length of stay and mortality rate. The principal purpose of this review is to provide an overview of the perioperative lung protection strategies in patients undergoing elective noncardiothoracic surgery, informing clinicians on evidence-based perioperative care pathways. We also conducted a systematic review and meta-analysis of randomized controlled trials in noncardiothoracic surgery focusing on the following aspects preoperative physiotherapy, intraoperative protective mechanical ventilation, postoperative prophylactic continuous positive airway pressure (CPAP) or high-flow nasal cannula (HFNC), and postoperative physiotherapy. Both preoperative physiotherapy (relative risk [RR], 0.49, 95% confidence interval [CI], 0.35-0.69, P less then .01) and postoperative CPAP (RR, 0.53, 95% CI, 0.30-0.94, P = .029) reduced the incidence of PPCs. Intraoperative protective mechanical ventilation had unclear effects (RR, 0.90, 95% CI, 0.77-1.06, P = .22). No benefits were observed for HFNC (RR, 0.88, 95% CI, 0.70-1.11, P = .30) and physiotherapy regimens administered in the postoperative period only (RR, 0.89, 95% CI, 0.69-1.16, P = .40). Lung-protective strategies should be considered throughout the entire perioperative period. The prophylactic use of strategies initiated in the postoperative period only, such as physiotherapy, CPAP, or HFNC, offers limited benefits. Physiotherapy and patient training should be started early in the preoperative phase, and intraoperative protective mechanical ventilation should be titrated on an individual basis taking into account all the available evidence.Musculoskeletal injuries are common following trauma and variables that are associated with late femur fracture fixation are important to perioperative management. Furthermore, the association of late fracture fixation and multiple organ failure (MOF) is not well defined.
We performed a retrospective cohort investigation from 2 academic trauma centers.
age 18-89 years, injury severity score (ISS) &gt;15, femoral shaft fracture requiring operative fixation, and admission to the intensive care unit &gt;2 days. Admission physiology variables and abbreviated injury scale (AIS) scores were obtained. Lactate was collected as a marker of shock and was described as admission lactate (LacAdm) and as 24-hour time-weighted lactate (LacTW24h), which reflects an area under the curve and is considered a marker for the overall depth of shock. The primary aim was to evaluate clinical variables associated with late femur fracture fixation (defined as ?24 hours after admission). A multivariable logistic regression model tested variables associated with late fixation and is reported by odds ratio (OR) with 95% confidence interval (CI).